Search

To systematically assess the effect of negative pressure wound therapy (NPWT) on postoperative surgical wound infection, length of hospital stay and postoperative complications after spinal surgery. Relevant studies on the application of NPWT in spinal surgery were conducted via a computerised database search, including PubMed, EMBASE, Web of Science, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang, from inception to June 2023. The identified literature was rigorously screened and data extraction was performed by two investigators independently. The quality of the relevant studies was evaluated using the Newcastle–Ottawa scale (NOS). The effect size for count data was determined by the odds ratio (OR), while the impact size for measurement data was expressed as the standardised mean difference (SMD). The 95% confidence interval (CI) was calculated for each effect magnitude. Stata 17.0 software was used for the meta‐analysis. Ten papers, totalling 1448 patients, were finally included. This study demonstrated that NPWT led to a statistically significant reduction in the occurrence of postoperative surgical wound infections (OR: 0.377, 95% CI: 0.238–0.598, p < 0.001), fewer postoperative complications (OR: 0.526, 95% CI: 0.360–0.770, p = 0.001) and a shortened hospital stay (SMD: −0.678, 95%CI: −1.324 to −0.031, p = 0.040) after spinal surgery compared with the control group. When compared with other treatment approaches, NPWT also demonstrated a substantial reduction in surgical wound infections and postoperative complications, as well as a shorter duration of hospitalisation after spinal surgery. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]

Background: Neoadjuvant chemoimmunotherapy (NCIT) for locally advanced esophageal squamous cell carcinoma (ESCC) is supported by increasing data, but the sample size is limited, and the findings are not completely consistent. We conducted a real‐world study and a meta‐analysis to evaluate the efficacy and safety of NCIT in locally advanced ESCC. Methods: We retrospectively assessed the outcomes of patients with locally advanced ESCC who completed NICT and subsequent esophagectomy at our hospital between January 2019 and December 2022, including pathological complete response (pCR) rate, major pathological response (MPR) rate, 1‐, 2‐, and 3‐year overall survival (OS) rates, disease control rate (DCR), objective response rate (ORR), 1‐year recurrence rate, R0 resection rate and adverse events. Moreover, a meta‐analysis of 27 published literatures was also conducted for comparison. Results: In the analysis, 128 patients were studied, with 25% achieving pCR, 46.1% MPR, and 99.2% R0 resection. The 1‐, 2‐, and 3‐year OS rates were 91.41% (95% CI: 85.15%–95.63%), 75.00% (95% CI: 66.58%–82.23%) and 64.84% (95% CI: 55.91%–73.07%).ORR and DCR were 31.2% (95% CI: 23.31–39.99) and 64.1% (95% CI: 55.15%–72.38%), and the 1‐year recurrence rate was 26.7% (95% CI: 22.5%–38.1%). Treatment‐related events occurred in 96.1% but were acceptable. In a meta‐analysis of 27 studies with 1734 patients, pooled rates for pCR, MPR, ORR, DCR, and R0 resection were 29%, 52%, 71%, 97%, and 98%, respectively, with a 1‐year recurrence rate of 12%. Conclusion: NCIT is safe and provides potential survival benefits for patients with locally advanced ESCC. However, randomized phase 3 trial data is still needed. [ABSTRACT FROM AUTHOR]

Multidrug‐resistant (MDR) bacterial infections have become increasingly common in recent years due to the increased prevalence of diabetic foot ulcers (DFUs). We carried out a meta‐analysis aimed at investigating the prevalence of MDR bacteria isolated from DFUs and analysing the risk factors for MDR bacterial infection in patients with DFUs. The PubMed/Medline, Web of Science, Embase, Cochrane Library, Ovid, Scopus, and ProQuest databases were searched for studies published up to November 2023 on the clinical outcomes of MDR bacteria in DFUs. The main outcome was the prevalence of MDR bacteria in DFUs. A total of 21 studies were included, representing 4885 patients from which 2633 MDR bacterial isolates were obtained. The prevalence of MDR bacteria in DFUs was 50.86% (95% confidence interval (CI): 41.92%–59.78%). The prevalence of MDR gram‐positive bacteria (GPB) in DFUs was 19.81% (95% CI: 14.35%–25.91%), and the prevalence of MDR gram‐negative bacteria (GNB) in DFUs was 32.84% (95% CI: 26.40%–39.62%). MDR Staphylococcus aureus (12.13% (95% CI: 8.79%–15.91%)) and MDR Enterococcus spp. (3.33% (95% CI: 1.92%–5.07%)) were the main MDR‐GPB in DFUs. MDR Escherichia coli, MDR Pseudomonas aeruginosa, MDR Enterobacter spp., MDR Klebsiella pneumoniae, and MDR Proteus mirabilis were the main MDR‐GNB in DFUs. The prevalence rates were 6.93% (95% CI: 5.15%–8.95%), 6.01% (95% CI: 4.03%–8.33%), 3.59% (95% CI: 0.42%–9.30%), 3.50% (95% CI: 2.31%–4.91%), and 3.27% (95% CI: 1.74%–5.21%), respectively. The clinical variables of diabetic foot ulcer patients infected with MDR bacteria and non‐MDR bacteria in the included studies were analysed. The results showed that peripheral vascular disease, peripheral neuropathy, nephropathy, osteomyelitis, Wagner's grade, previous hospitalization and previous use of antibacterial drugs were significantly different between the MDR bacterial group and the non‐MDR bacterial group. We concluded that there is a high prevalence of MDR bacterial infections in DFUs. The prevalence of MDR‐GNB was greater than that of MDR‐GPB in DFUs. MDR S. aureus was the main MDR‐GPB in DFUs, and MDR E. coli was the main MDR‐GNB in DFUs. Our study also indicated that peripheral vascular disease, peripheral neuropathy, nephropathy, osteomyelitis, Wagner's grade, previous hospitalization, and previous use of antibacterial drugs were associated with MDR bacterial infections in patients with DFUs. [ABSTRACT FROM AUTHOR]

A meta‐analysis was executed to comprehensively examine the impacts of enhanced recovery after surgery (ERAS) care interventions on complications and wound infections following bladder cancer (BCa) surgery. Computer searches were carried out in Embase, Google Scholar, Cochrane Library, PubMed, Wanfang and CNKI, from their inception to November 2023, for RCTs regarding perioperative ERAS nursing interventions in patients with BCa. Two independent researchers performed literature screening, extracted data and carried out quality evaluations. Stata 17.0 software was utilized for the analysis of the data. Ultimately, 16 RCTs, involving 1190 patients, were included. The analysis showed that, in comparison with conventional nursing methods, perioperative ERAS nursing application in patients with BCa remarkably decreased the occurrence of wound infections (OR: 0.31, 95% CI: 0.16–0.59) and complications (OR: 0.19, 95% CI: 0.13–0.28). Our study indicates that perioperative care based on the ERAS concept remarkably decreased the occurrence of wound infections and complications following BCa surgery, demonstrating notable nursing efficacy and meriting widespread clinical promotion. [ABSTRACT FROM AUTHOR]

In this study, a meta‐analysis was conducted to assess the effect of refined nursing interventions in the operating room on the incidence of surgical‐site wound infections in patients undergoing lung cancer surgery to provide an evidence base for the prevention and management of nosocomial infections. A computerised literature search was used to identify randomised controlled trials (RCTs) on the application of refined nursing interventions in the operating room in patients undergoing lung cancer surgery published in the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP and Wanfang databases from their inception until July 2023. The literature screening, data extraction and quality assessment of the included studies were performed independently by two researchers. RevMan 5.4 software was used for the meta‐analysis. Twenty‐eight studies were included in the analysis, with a total of 2406 patients, including 1210 patients in the refined nursing intervention group and 1196 patients in the control group. The results of the meta‐analysis showed that the refined nursing interventions in the operating room significantly reduced the incidence of surgical‐site wound infections in patients undergoing lung cancer surgery, compared with the control group (1.82% vs. 6.52%, odds ratio: 0.30, 95% CI: 0.19–0.47, p < 0.001), and shortened the length of hospital stay (standardised mean difference: −1.51 days, 95% CI: −1.92 to −1.11 days, p < 0.001). Current evidence suggests that the application of refined nursing interventions in the operating room is effective at reducing the incidence of surgical‐site wound infections and shortening the length of hospital stay in patients undergoing lung cancer surgery. However, owing to the small number and low quality of the studies, more high‐quality RCTs with large sample sizes are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Aim: To critically assess the effects of white noise on the pain level, weight gain and vital signs (heart rate, respiratory rate and oxygen saturation) of preterm infants in neonatal intensive care units (NICUs). Design: A systematic review and meta‐analysis of randomised controlled trials (RCTs). Methods: Ten databases (PubMed, Cochrane Library, Embase, Web of Science, CINAHL, PsycINFO, SinoMed, China National Knowledge Infrastructure, VIP and Wanfang Data) were systematically reviewed from inception to July 2022. Two reviewers evaluated the risk of bias separately using the Cochrane Collaboration criteria and extracted data using a predesigned information form. Results: The meta‐analysis included eight eligible RCTs. According to statistical analysis, white noise significantly affected the pain level, weight gain, heart rate, respiratory rate and oxygen saturation in preterm infants. Regardless of the outcome measurement timing, gestational age and birth weight of preterm infants, subgroup analysis demonstrated that white noise reduced the pain level, heart rate and respiratory rate and promoted weight gain in preterm infants in NICUs. Conclusion: White noise is a practical and potentially useful therapy for premature neonates in NICUs. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims: To identify the incidence, prevalence and risk factors of exposure keratopathy (EK) among critically ill patients. Design: Systematic review and meta‐analysis, in accordance with the PRISMA 2020 Statement. Methods: The Cochrane Library, PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China Knowledge Resource Integrated Database (CNKI), Chinese Biomedical Database (CBM), Weipu Database (VIP) and WanFang Database were systematically searched from inception to June 2022. Observational studies that reported EK among paediatric and adult critically ill patients were screened and included original articles based on the inclusion criteria. Two reviewers independently completed data extraction and quality assessments. Subgroup analysis investigated potential causes of heterogeneity. Results: Of the 4508 studies identified, 23 studies involving 3519 subjects were included. The pooled prevalence of EK was 34.0%, and the pooled incidence rate of EK was 23.0%. Risk factors associated with EK in critically ill patients included lagophthalmos, chemosis, eye blinks <5 times per minute, mechanical ventilation, sedation, lower Glasgow Coma Scale (GCS) score and higher Acute Physiology and Chronic Health Evaluation (APACHE) II score. Conclusion: This review shows that EK rates are high in critically ill patients and are influenced by multiple factors. Medical staff should pay more attention to EK in critically ill patients, conduct professional evaluations and implement targeted eye care protocols to reduce its occurrence. Implications for Practice: This study shows the frequency of and multiple risk factors for EK in critically ill patients, which provides evidence‐based guidance for nurses to evaluate the risk of EK in critically ill patients and take appropriate precautions to reduce the risk. Protocol Registration: The protocol was registered in PROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42022346964). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

A meta‐analysis was performed to comprehensively assess the effects of video‐assisted thoracoscopy on surgical site wound infection and wound pain in patients with lung cancer. Studies on video‐assisted thoracoscopy for lung cancer were collected from PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang database, from inception to January 2023. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the included studies according to the inclusion and exclusion criteria. Meta‐analysis was performed using RevMan 5.4 software. Thirty‐one articles with a total of 3608 patients were included, with 1809 in the video‐assisted thoracoscopy group and 1799 in the control group. Compared with the control group, video‐assisted thoracoscopy significantly reduced surgical site wound infection (odds ratio: 0.22, 95% confidence interval [CI]: 0.14–0.33, P <.001) and surgical site wound pain at postoperative day 1 (standardised mean difference [SMD]: −0.90, 95% CI: −1.17 to −0.64, P <.001) and postoperative day 3 (SMD: −1.59, 95% CI: −2.25 to −0.92, P <.001). Thus, these results showed that video‐assisted thoracoscopy may have beneficial outcomes by reducing surgical site wound infection and pain. However, owing to the large variation in sample sizes and some methodological shortcomings, further validation is needed in future studies with higher quality and larger sample sizes. [ABSTRACT FROM AUTHOR]

Background Late course accelerated hyperfractionation radiotherapy ( LCAHR) is used as a standard treatment option for locally advanced esophageal squamous cell carcinoma ( LAESCC) in China, but concerns remain regarding its efficacy and safety. The purpose of this paper was to evaluate the efficacy and safety of LCAHR. The comparisons examined were as follows: LCAHR versus conventional fractionation radiotherapy ( CFR) and LCAHR plus chemotherapy ( CT) versus LCAHR alone. Methods We searched the Cochrane Library, MEDLINE, EMBASE, CENTRAL, CBMdisc, and CNKI, as well as employing manual searches. The primary end points were survival and local control. The second end point was toxicities. Results Based on search criteria, we found 29 trials involving 3187 patients. Our results showed that LCAHR, compared with CFR, improved the survival and local control, and was, thus, more therapeutically beneficial. Further analysis revealed that LCAHR plus CT proved to be better for patients' survival and local control compared to LCAHR alone. Acute toxicities were increased rather than late toxicities. Conclusions There was a significant survival and local control benefit of LCAHR over CFR, as well as LCAHR plus CT over LCAHR alone. Considering the strength of the evidence, the results of this study indicate that this regimen would be a new promising modality worth further investigation. [ABSTRACT FROM AUTHOR]

Background: Studies on the association between adverse birth outcomes and dental caries in children have shown conflicting results, so the aim of this systematic review and meta‐analysis was to investigate the association between adverse birth outcomes and dental caries in children. Methods: We systematically searched articles in four electronic databases (Web of Science, PubMed, Cochrane Library and Embase) published prior to August 2021. The odds ratio (OR) (or converted OR) and the corresponding 95% confidence intervals (95% CI) were processed. The certainty of evidence was assessed using GRADE's risk bias assessment tool. Random effects model was used for this meta‐analysis. Results: A total of thirty‐one observational studies met the inclusion criteria. The pooled estimates indicated that children exposed to low birth weight (LBW)/preterm birth (PTB) did not experience higher dental caries in primary teeth. Subgroup analyses showed that children with LBW (OR: 1.30, 95% CI: 1.03–1.63) were prone to have dental caries in primary teeth for cross‐sectional studies, but no significant differences for prospective studies. PTB children experienced more primary caries in high‐income countries (OR: 1.31, 95% CI: 1.00–1.70) than in low‐ and middle‐income countries. Conclusions: The current evidence did not suggest a significant association between LBW and dental caries in children for primary teeth. Children with PTB in high‐income countries had a higher prevalence of primary dental caries. Further prospective studies should adjust for confounding factors (age, oral health and family finances) to determine the definitive association between LBW/PTB and dental caries. [ABSTRACT FROM AUTHOR]

Physical distancing and contact restrictions have been implemented in most countries and territories due to the rapid spread of SARS‐CoV‐2. This has caused physical, emotional, and psychological distress for adults living in the community. Diversified telehealth interventions have been widely applied in health care and have proven to be cost‐effective and well accepted by patients and health professionals. Currently, the effectiveness of telehealth interventions on psychological outcomes and quality of life among community adults during the COVID‐19 pandemic remains unclear. A literature search was conducted using PubMed, PsycINFO, CINAHL, EMBASE, MEDLINE, and the Cochrane Library from 2019 to October 2022. Twenty‐five randomized controlled trials with 3228 subjects were finally included in this review. Two independent reviewers performed the screening, extraction of key data points, and appraisal of the methodological quality. There were positive effects of telehealth interventions on anxiety, stress, loneliness, and well‐being among community adults. Participants who were women or older adults were more likely to recover from negative emotions, increase well‐being, and improve quality of life. The real‐time and interactive interventions and remote cognitive‐behavioural therapy (CBT) may be better choices during the COVID‐19 pandemic. Based on the findings of this review, health professionals have more options and alternatives for delivering telehealth interventions in the future. Rigorously designed randomized controlled trials (RCTs) with higher statistical power and long‐term follow‐up should be conducted in the future to strengthen the currently weak evidence. [ABSTRACT FROM AUTHOR]

Objective: This meta‐analysis aimed to determine the effect of mindfulness interventions on nurses' levels of depression and anxiety. Design: Meta‐analysis of randomised controlled trials. Methods: The following Chinese and English databases were searched: PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Internet (CNKI). The retrieval period was from database construction to 30 March 2022. Two researchers screened the relevant literature and extracted the data. After a cross‐check, data were input into Stata version 16.0 for meta‐analysis. Results: Twelve randomised controlled trials from 2017 to 2021 were included, which involved 807 subjects (405 and 402 in the intervention and control groups, respectively). Meta‐analysis results showed that nurses' anxiety reduced by mindfulness‐based interventions was significantly higher compared to that of the control group (SMD = 0.91, 95% CI: 0.27–1.55, p < 0.05). Furthermore, an 8‐week mindfulness‐based intervention (SMD = 1.43, 95% CI: 0.61–2.24) reduced the level of anxiety significantly more compared to a 4‐week intervention (SMD = 1.03, 95% CI: 0.36–1.71). Mindfulness‐based interventions were better compared to conventional intervention to reduce the level of depression (SMD = 1.02, 95% CI: 0.42–1.61, p < 0.05), and an 8‐week mindfulness intervention (SMD = 1.81, 95% CI: 0.78–2.84) reduced the level of depression significantly more compared to a 4‐week intervention (SMD = 0.82, 95% CI: 0.29–1.35). Since limited studies had interventions longer than 8 weeks, results on longer mindfulness interventions in reducing nurses' anxiety and depression are inconclusive. In conclusion, mindfulness intervention for 8 weeks or less can significantly reduce nurses' anxiety and depression levels. Patient or Public Contribution: None. [ABSTRACT FROM AUTHOR]

Background: Recently, the attempts to promote advance care planning (ACP) and advance directives (ADs) have appeared in mainland China. However, anecdotal evidence suggests that the concept of ACP and ADs is not widely known to the public and healthcare professionals. Aim: To examine and synthesise currently available research about ACP and ADs for older people in mainland China, and to discuss implications for future nursing practice and research. Design: An integrative literature review. Methods: A systematic search was conducted in seven English electronic databases (CINAHL, MEDLINE, ProQuest, Cochrane, JBI, Scopus and Wiley) and four Chinese electronic databases (CNKI, Wanfang, VIP and CBM). Eligible articles were critically appraised using the Mixed Methods Appraisal Tool (MMAT). Findings: From various groups including older people, families and healthcare professionals, low levels of knowledge and awareness about ACP and ADs are reported. Demographic characteristics such as age, gender, education and clinical conditions were related to positive or negative attitude towards ACP. The main reason people cited for being 'reluctant/fairly reluctant' to make an AD was that they were 'Not familiar with it'. Conclusions: Given that older people showed positive attitudes towards ACP, policy support and practice guidelines about ADs and ACP are necessary to respect their wishes and to guide healthcare professionals in mainland China. [ABSTRACT FROM AUTHOR]

Aim: To determine the efficacy of Internet‐based interventions in decreasing the prevalence of postpartum depression in perinatal women. Design: This review was conducted according to the standards outlined in the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. Methods: We performed a systematic meta‐analysis of randomized controlled trials on the efficacy of Internet‐based interventions for postpartum depression. Studies (2008–2018) were identified through a search conducted on PubMed, EMBASE and the Cochrane Library. Risk ratios or weighted mean differences with 95% confidence intervals were calculated using a fixed‐effects model or a random‐effects model. Stata software 11.0 was used to perform the meta‐analysis. Results: Most of the seven eligible studies were randomized controlled trials. The random‐effects model indicated that Internet‐based interventions significantly improved postpartum depression (d = 0.642, N = 7). Attrition rates ranged from 4.5%–86.9% and from 0%–87.1% for the intervention and control groups, respectively. [ABSTRACT FROM AUTHOR]

Background: Multidrug‐resistant tuberculosis (MDR‐TB) brings major challenges to the health care workers (HCWs). This study is to determine the risk factors for MDR‐TB, latent tuberculosis infection (LTBI), and tuberculosis (TB) disease among HCWs in China. Methods: A meta‐analysis was conducted to evaluate the risk factors for MDR‐TB, LTBI, and TB disease among HCWs using a random‐effects model, and the pooled odds ratios (ORs) with 95% confidence interval (CI) were used as effect indicators. Results: We identified 46 eligible studies and found eight factors were associated with MDR. The ORs with 95% CI are migrant population 1.96 (95% CI, 1.50–2.57), low family income 2.23 (95% CI, 1.74–2.85), retreatment 7.22 (95% CI, 5.63–9.26), anti‐TB treatment history 5.65 (95% CI, 4.80–6.65), multiple episodes of treatment 3.28 (95% CI, 2.60–4.13), adverse reactions 3.48 (95% CI, 2.54–4.76), interrupted treatment 3.18 (95% CI, 2.60–3.89), and lung cavities 1.42 (95% CI, 1.14–1.77). Work duration as a HCW for 5 years and above increased the risk of LTBI and TB. HCWs aged 30 years and above were more susceptible to TB (OR = 1.70, 95% CI: 1.37–2.09). Conclusion: The risk factors for MDR‐TB in China are possibly migrant population, low family income, retreatment, anti‐TB treatment history, adverse reactions, interrupted treatment, and lung cavities. Longer work duration and greater age are risk factors for LTBI and TB among HCWs. [ABSTRACT FROM AUTHOR]

In this systematic review and meta-analysis, we evaluated the effectiveness, safety and comfort of StatLock for the securement of peripherally-inserted central catheters. PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, WanFang Database, and China Science and Technology Journal Database were searched. Randomized, controlled trials comparing StatLock with tape or suture on the performance of securing peripherally-inserted central catheters were selected. Meta-analysis was performed using Review Manager 5.3 software. Thirteen randomized, controlled trials involving 1970 patients were included. Our results showed that StatLock reduced the incidence of catheter dislodgement and unplanned removal. Moreover, patients in the StatLock group had lower incidence of skin ulceration, phlebitis, catheter-related bloodstream infection, and cellulitis, and felt more comfortable compared with those in the control group. Current evidence suggests that the StatLock securement device offer advantages over tape and suture in preventing catheter-related complications and improving patient comfort. However, as considerable heterogeneity was found among the included studies, and the quality of evidence for main outcomes was relatively low, the results should be viewed with caution. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Public reporting of performance data is one of the most popular topics in health care field. The aim of this study was to investigate the transparency mechanism, that is, how public reporting influenced general practitioners' ( GPs) prescribing practices. Method GPs who had the license to prescribe medicine of all 10 primary care institutions were surveyed. Data were collected by an instrument, which exhibited satisfactory reliability and validity ( Cronbach's alpha > 0.7; average variance extracted > 0.5; composite reliability > 0.7). Data analysis was conducted by structural equation model. Results The results showed that GPs' perceived value ( GP's overall assessment of the worth of the public reporting) and attitude (the psychological reaction to public reporting) had a significantly direct effect on behavioural intention ( r = 0.28; r = 0.36), and were affected by information accessibility ( r = 0.63; r = 0.32). Attitude had a significant effect on perceived value( r = 0.45). Perceived risk (the perceptions of the possible loss due to public reporting, e.g. decreasing their income) did not have a significant relationship with information accessibility, attitude and behavioural intention( r = −0.09; r = 0.01; r = −0.07). Conclusion The information accessibility, perceived value and attitude have strong effects on prescribing practices of GPs, whereas perceived risk did not play a role in influencing the prescribing practices. Policymakers need to improve the accessibility of prescription quality indicators and pay attention to the perceived values and attitudes of GPs. Policymakers also need to strengthen the risk education of GPs and attach incentives to transparent regulation. [ABSTRACT FROM AUTHOR]

Rationale aims and objectives The extension of the Consolidated Standards of Reporting Trials ( CONSORT) statement provides reporting guidelines to improve the reporting quality of randomized controlled trials ( RCTs). This present study was aim to assess the reporting quality of abstracts of RCTs on clinical pathway. Methods Eight databases were searched from inception to November 2012 to identify RCTs. We extracted basic information and CONSORT items from abstracts. Each abstract was assessed independently by two reviewers. Statistical analyses were performed with SPSS 13.0. Level of significance was set at P < 0.05. Results 328 abstracts were included. 300 (91.5%) were published in Chinese, of which 292 were published on high impact factor journals. 28 English abstracts were all published on Science Citation Index ( SCI) journals. (1) Intervention, objective and outcome were almost fully reported in all abstracts, while recruitment and funding were never reported. (2) There are nine items ( P < 0.05) in Chinese that were of low quality compared with in English. There was statistically difference on total score between Chinese and English abstracts ( P < 0.00001). (3) There was no difference in any items between high and low impact factor journal in China. (4) In SCI journals, there were significant changes in reporting for three items trial design ( P = 0.026), harms ( P = 0.039) and trial registration ( P = 0.019) in different periods (pre- and post- CONSORT), but only the numbers of randomized ( P = 0.003) changed in Chinese abstracts. Conclusions The reporting quality of abstracts of RCTs on clinical pathway still should be improved. After the publication of CONSORT for abstracts guideline, the RCT abstracts reporting quality were improvement to some extent. The abstracts in Chinese journals showed non-adherence to the CONSORT for abstracts guidelines. [ABSTRACT FROM AUTHOR]

Background Although the regular consumption of green tea or green tea extract has been considered to improve insulin sensitivity, the reported results are inconsistent. Therefore, we conducted a meta-analysis to evaluate the effect of green tea or green tea extract on insulin sensitivity and glycaemic control in populations at risk of type 2 diabetes mellitus (T2 DM). Methods Electronic databases, including PUBMED, The Cochrane Library, EMBASE, ISI Web of Knowledge, Chinese Biomedical Literature Database and Chinese Scientific Journals Fulltext Database, were systematically searched to identify randomised controlled trials ( RCTs) up to December 2011, supplemented by the websites and the reference lists of identified studies. Two reviewers independently selected trials, extracted data, and evaluated the methodological qualities and evidence levels. Results Seven RCTs involving 510 participants were identified. There was no statistically significant difference between green tea or green tea extract group and placebo group with regard to fasting plasma glucose [standardised mean difference ( SMD) 0.04; 95% confidence interval ( CI) −0.15 to 0.24], fasting serum insulin ( SMD −0.09; 95% CI −0.30 to 0.11), 2-h plasma glucose in the oral glucose tolerance test ( OGTT−2 h) ( SMD −0.14; 95% CI −0.63 to 0.34), haemoglobin A1c ( SMD 0.10; 95% CI −0.13 to 0.33) and homeostasis model of insulin resistance ( HOMAIR) index ( SMD −0.06; 95% CI −0.35 to 0.23) in participants at risk of T2 DM. Conclusions The consumption of green tea did not decrease the levels of fasting plasma glucose, fasting serum insulin, OGTT−2 h glucose, haemoglobin A1c and HOMAIR in populations at risk of T2 DM. Larger, longer-term and high-quality RCTs are needed to further definitely determine the effect of green tea or green tea extract on insulin sensitivity and glycaemic control in populations at risk of T2 DM. [ABSTRACT FROM AUTHOR]